Observational Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2014; 20(32): 11394-11399
Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11394
Utility of the Asia-Pacific colorectal screening scoring system and the presence of metabolic syndrome components in screening for sporadic colorectal cancer
Jiang-Yuan Wang, Zhen-Tao Li, Yuan-Min Zhu, Wen-Chao Wang, Yan Ma, Yu-Lan Liu
Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People’s Hospital, Beijing 100044, China
Zhen-Tao Li, Department of Gastroenterology, People’s Hospital of Dengfeng, Dengfeng 452470, Henan Province, China
Wen-Chao Wang, People’s Hospital of Pu’er, Pu’er 665000, Yunnan Province, China
Yan Ma, People’s Hospital of Lvliang, Lvliang 033000, Shanxi Province, China
Author contributions: Zhu YM and Liu YL contributed to the concept and design of the study, and provided final approval of the version to be published; Wang JY performed the majority of data analysis, drafted the article and revised it for important intellectual content; Li ZT performed the collection of the clinical data; Wang JY and Li ZT contributed equally to this work; Wang WC and Ma Y participated in data collection; all the authors confirmed that they had reviewed the manuscript and approved its publication.
Supported by Capital Health Research and Development of Special, No. 2011-4022-06
Correspondence to: Yuan-Min Zhu, MD, Department of Gastroenterology, Peking University People’s Hospital, No.11 Xizhimen South Street, Beijing 100044, China. zhuyuanmin@sina.com
Telephone: +86-10-88324780 Fax: +86-10-88324780
Received: January 22, 2014
Revised: April 4, 2014
Accepted: April 30, 2014
Published online: August 28, 2014
Processing time: 218 Days and 14.6 Hours
Abstract

AIM: To determine the utility of the Asia-Pacific colorectal screening (APCS) scoring system and metabolic syndrome components in individual screening for sporadic colorectal cancer.

METHODS: The subjects were patients admitted to the Peking University People’s Hospital for colonoscopy between October 2012 and July 2013. Clinical information, including patient willingness to undergo colonoscopy, medical history, endoscopic findings, histology, and other information, was collected, and the patients were grouped according to APCS scores and the presence of metabolic syndrome components. Colorectal tumor detection rates were compared between the groups.

RESULTS: A total of 219 patients were included in the study, 108 were male and 111 were female, resulting in a male-to-female ratio of 1:1.03. The average age of the patients was 56.8 ± 13.7 years. According to APCS scores, 88 (40.2%) patients were included in the average-risk (AR) group, 113 (51.6%) patients were included in the moderate-risk (MR) group, and 18 (8.2%) patients were included in the high-risk (HR) group. Colorectal tumors were detected in 69 (31.5%) subjects, and the detection rates in the AR, MR, and HR groups were 15.9%, 36.3%, and 77.8%, respectively. The difference in the detection rates between the three groups was statistically significant (P < 0.01). The combined detection rate of colorectal tumors in the APCS MR and HR groups was 42.0%. However, patients in the MR and HR groups who presented with metabolic syndrome components, in particular obesity, exhibited a significantly higher colorectal tumor detection rate (59.5%) than did those without these components (19.2%, P < 0.01) and those who underwent colonoscopy because of doctor’s recommendation (36.5%, P < 0.01).

CONCLUSION: The APCS scoring system can be used in individual screening for sporadic colorectal cancer. The combined use of APCS scores and the metabolic syndrome components, in particular obesity, will significantly improve the efficacy of individual colorectal cancer screening.

Keywords: Asia-Pacific colorectal screening scoring system; Metabolic syndrome; Obesity; Colorectal cancer; Individual screening

Core tip: This study assessed the utility of the Asia-Pacific colorectal screening (APCS) scoring system and the presence of metabolic syndrome components in outpatient screening for colorectal cancer (CRC) by stratifying individuals according to these parameters. The APCS scoring system can be used in individual screening for sporadic CRC. The combined use of APCS scores and the metabolic syndrome components, in particular obesity, will significantly improve the efficacy of colorectal cancer screening.